Chasing the scent of Love, Truth, Beauty, and Mirth, wherever it may lead.

Wednesday, April 17, 2013

Standing Up for Medicare

Don’t
Be Fooled by the “Reformers”

In
the ongoing ruckus over “entitlements,” saving Social Security is one thing,
but what about Medicare? It’s got more baggage, a program Lyndon Johnson shoved
through Congress in the 1960s, thinking we could have a Great Society and an
expanding war at the same time without going broke. He was wrong. In pursuing
both, we achieved neither.

And
now that our wars, having gone global, cost much more but are kept more hidden
from public scrutiny, we’re left discussing whether we can afford Lyndon
Johnson’s Great Society any longer. Medicare is the primary target for
“reform,” though one wonders why so little is mentioned about Medicaid. If you
weaken Medicare, don’t you drive many people straight into Medicaid?

In
any case, Medicare, with all its flaws, has been a life-saver for me. My
retirement plan was never to retire. I figured I was healthy enough, enjoyed my
patchwork of part-time jobs, and, no matter what happened, I could always
write.

But
the world changed as I and the nation suffered simultaneous heart failure. It
hit me when it hit most people, in 2007-2008, when the real estate market
buckled, then collapsed, and I went into the hospital with persistent chest
pains. When I came out the old economy was gone.

I
found new life during the Great Recession, but my old habits were in tatters.
For one thing, one of my primary jobs disappeared in the economic carnage, so I
had a lot more free time but also a lot less money. Fortunately, I had Medicare.

But
now the politicians want to “reform” Medicare. This is a red flag. In Washington, as we saw with welfare, reform does not
mean improve so it works better. It means tear down, limit, withhold. Not that
Medicare doesn’t need improvement. But, fundamentally, it gives me and millions
of others access to basic health care and emergency help, too, if we need it.
When reform means tear down and redistribute public funds to private,
profit-driven companies, I see a bad scene coming. It may not hurt me too much,
but it’s likely to hurt those younger than me a whole lot.

The
aggravating thing is, Medicare works pretty well. If there’s a problem with it,
it’s not government. It’s greed, infecting the for-profit health care system we
Americans cling to. Opponents of Medicare want our payroll-tax money—and
more—for themselves. Our health care is secondary to the pressure on the
medical industry to profit a large number of investors in insurance and
pharmaceutical companies, hospitals, medical suppliers, and the list could go
on. But when the patient and the doctor—that primary relationship—are not
central to health care, how can we expect the quality of that care to be
anything but “fast medicine,” as my ex-primary doctor called it before he quit
his practice?

Too
little, when you need it most. Too late, when it might have done you the most
good. Diagnosis and treatment, hit or miss. If the doctors finally get it
right, which, admittedly, they often do, you pay for their misses. That’s the
American health-care system for most people.

So
real reform would begin with defining the purpose behind health care in the
first place. Is it for private profit? Or is it for public health? And what
about individual choice in the matter?

These
are decisions for the government to make, and the government is beholden to the
people. So it’s a decision each one of us must make and notify our government
with our voices and with our vote.

As
things stand now, a complacent government is so easy to rip off that many are
tempted to get in on the scam. Meanwhile, insurance companies are cleaning up
on Obamacare, with more to come down the road when the demons of competition
are unleashed in full. Obviously our health care system, even under Obamacare,
is fundamentally flawed. It rewards the cheaters, under-serves the deserving,
and moves a steady flow of cash to investors.

I
support single-payer health insurance or Medicare for All (MFA). Even President
Obama admitted (once) that single-payer is the least costly alternative to all other
plans put forward, including his own, because it doesn’t need to profit from
services rendered.

But could the financial system take
the shock of MFA? There would be chaos on Wall Street and panic throughout the
industry if health care shifted to the government.

Yet,
from all I’ve read, the cost of health care would come down, and, with everyone
covered, the health of the general population would likely improve.

Why isn’t that at least part of the
discussion about reform?

Many
Americans flinch at the idea of socialism, but neither capitalism nor socialism
is necessarily democracy, whose idea is more far-reaching than either.
Therefore a wise democracy will sometimes be socialistic, sometimes
capitalistic, and sometimes, in the brilliance of its freedoms, create the
unexpected, something entirely new.

Unless
someone comes up with that entirely new something, Medicare is the best
insurance for the money on the market, and MFA would be the most efficient,
least expensive health-care plan for the entire country. The only problem is a
lot of folks invested in the present system, who expect continuing, growing
returns on their money, oppose changes that could threaten profits, even if
earned at the expense of the sick, the poor, and the elderly.

It
could be a long debate—between the profitability of a burgeoning industry and a
culture’s quality of life and health. History does not favor the latter, but
routinely idealists have moved history.

(For related articles on this subject, see Thinking Dog Archives for "Health Care: The Tipping Point," published on June 18, 2009, and "Is Health Care a Civil Right?" published on Sept. 3, 2009.)